Deadliest encephalitis outbreak likely this year

Encephalitis, a mosquito-borne disease that preys on the young and malnourished is sweeping across eastern UP again this monsoon season, with officials worried it could be the deadliest outbreak in nearly a decade.

The authorities say the disease has already killed at least 118 children this year. The death toll may reach about 1000, says Dr RN Singh of the Encephalitis Eradication Movement, a nonprofit organisation.

While efforts against polio and tuberculosis get plenty of attention, the poor farmers and day labourers of eastern Uttar Pradesh face an almost-silent emergency, battling a disease that has killed thousands of children over the past eight years. Many families have taken out crushing loans for treatment. The children who survive often cannot communicate because of brain damage. Some are so severely disabled that their impoverished parents are told to abandon them.

Sangita Devi’s four-year-old son Anup Kumar has been in a hospital for four months. “We have mortgaged our house for our son’s treatment. But there is no improvement in his condition. He cannot even stand now,” she says.

The disease is predictable and preventable. Every year, the monsoon fills the region’s parched paddy fields, heralding the arrival of the mosquitoes that spread Japanese encephalitis from pigs to humans, devastating malnourished children with low immunity. Another strain of the disease - Acute Encephalitis Syndrome - spreads through contaminated water. Residents use the fields for defecation, contaminating the ground water.

A vaccine has long been available, but the authorities have failed to muster the sustained political will to focus on those hardest hit by the illness. The disease killed more than 1,500 children in 2005, the worst recent years.

Shocked by the deaths, the Allahabad high court in 2006 asked the state and central governments to declare encephalitis a national health emergency. “A concrete action plan must be drawn,” it says.

In 2006, the government started vaccinating children against Japanese encephalitis. The government vowed to immunise every child in the worst-affected areas and to launch a massive drive to improve sanitation. For a couple of years, the numbers dropped. In 2006, the disease killed 431 children. But the crowded hospital wards of the tiny town of Gorakhpur reflect how the immunisation drive has fizzled out. Last year, more than 700 children died.

Amid the cloying smells of ether and disinfectant, seven-year-old Amit jostled his mother. His words were slurred and, every time he tried to break free of her grip, he fell to the floor. She kissed his dry and dirty cheek. “He cannot stand on his own any more. He cannot speak. Cannot say whether he wants food or water. He has no control over his bladder,” says his mother, Kunti, as she holds him close.

Health experts say the government has made repeated mistakes in the fight against encephalitis. Most of the 7.5 million children vaccinated between 2006 and 2010 were given only a single dose of a two-dose vaccine, said Singh, of the Encephalitis Eradication Movement.